Chemotherapy is a cancer treatment procedure that consists of drugs. This is a non invasive medical management mode for cancer patients. The drugs are usually given through IV (Intravenous) route. But some drugs are given orally. In specific instances drugs are given directly into the abdominal cavity, pleural cavity (chest), or the bladder (urine reservoir in our body).
Chemotherapy drugs can limit the multiplying/dividing cancer cells. The chemo process also exerts its effect on the normal dividing/ multiplying cells of body, like blood cell- red blood cells, white blood cells, platelets, hair growth, nails and mucosa of stomach and intestine.
Chemotherapy drugs are quite toxic & these should be prepared/ handled/ given by personnel expert in giving chemotherapy. The dosage should be probably calculated taking into consideration, the height, weight & the body surface area of the patient. The patient has to go through a panel of tests- complete blood counts, liver function tests, kindly function tests creatinine clearance, cardiac test, before going through chemotherapy.
Any abnormally in the lab reports should be corrected before starting chemotherapy. Sometimes the dosage is modified, depending upon blood reports. Before staring actual chemotherapy, premedication drugs are given to minimize the side effects of chemotherapy. These are usually steroids & anti vomiting medicines. Steroids are given to combat any hypersensitivity reaction. During the installation of chemotherapy, the oncologist should ensure that the cannula is in the vein & properly secured, because leakage of chemotherapy drugs can lead to severe local inflammation, neurosis, sloughing, gangrene & patient may require surgery, plastic surgery & even amputation in extreme cases. The patient is advised to avoid raw fruits, salad, milk/ milk products, curd, and is advised to drink boiled/ RO water. He/ she is advised to avoid overexertion & eat presently cooked hygiene food.
Patient is advised medicine for vomiting control, TPN dose, vitamins, proteins etc. With some of the chemotherapy medicines, patients are prone to develop severe neutrophenia severe fall in white blood cells counts in the blood. These patients are given growth factors injection. Previously we had to give several of these injections. But now we have long acting growth factors (peglated version) where only one such injection is sufficient.
These patients are followed for two weeks. If they feel marked weakness, fever, severe vomitings, watery/ bloody stools, scanty urine, inability to take food, then blood counts & other laboratory tests are done. If the test are abnormal then patient is treated accordingly, in severe cases patients may be hospitalized.
Tips to remember on Chemotherapy and side effects:
- Chemotherapy drugs should be given by nurse with expertise in giving chemotherapy. Under supervision of an oncologist.
- Relevant blood testing should be done before giving chemotherapy.
- Leakage (Extravasation) of the chemo drugs can cause severe neurosis, sloughing
- Common side effects are vomiting, Neutropenia (decrease in Neutrophiles count of white blood cells), marked weakness, hair loss, watery stools, ulcers in mouth
- Proper diet & adequate fluids should be taken. During & throughout the course of chemotherapy.
- Most of the side effects can be prevented /controlled with advances in chemotherapy care. Growth factors & supportive treatment is required.
- Every chemotherapy has its own specific side effect, so the side effects of that particular drug/ drugs should be particularly taken into consideration.